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<head>
<meta charset="UTF-8" />
<title>Insert title here</title>
</head>
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<!-- 修改表格的JS -->
<script type="text/javascript" src='../bootStrapTable/js/jquery-3.2.1.min.js'></script>
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<script type="text/javascript" src='../member/insert.js'></script>

<body style="background: white;">
	<div class="main-container ace-save-state" id="main-container">
		<div class="main-content">
			<div class="main-content-inner">
				<div class="page-content">
					<div class="page-header">
						<h1>
							管理会员信息 <small> <i class="ace-icon fa fa-angle-double-right"></i> 增加
							</small>
						</h1>
					</div>
					<!-- /.page-header -->
					<div class="row">
						<div class="col-xs-12">
							<form class="form-horizontal form-actions" role="form" id='form' enctype="multipart/form-data">
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 会员卡号: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="    请输入会员卡号" id='rcard' class="col-sm-11" name='rcard' />
									</div>
									<label class="col-sm-1 control-label no-padding-right" for="form-field-1-1"> 会员姓名: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="    请输入会员姓名" id='rname' class="col-sm-11" name='rname' />
									</div>
								</div>
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 会员相片: </label>

									<div class="col-sm-3">
										<input type="file" id='fileimg' class="col-sm-11" name='fileimg' style="border: 1px solid #D5D5D5; background: white;" />
									</div>
									<label class="col-sm-1 control-label no-padding-right" for="form-field-1-1"> 手机号码: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="    请输入会员号码" id='rtel' class="col-sm-11" name='rtel' />
									</div>
								</div>
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 卡号密码: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="    请输入卡号密码" id='rpsw' class="col-sm-11" name='rpsw' />
									</div>
									<label class="col-sm-1 control-label no-padding-right" for="form-field-1-1"> 会员性别: </label>

									<div class="col-sm-3">
										<select id='rsex' class='col-sm-11' name='rsex'>
											<option value='3'>---请选择性别---</option>
											<option value='1'>男</option>
											<option value='0'>女</option>
										</select>
									</div>
								</div>
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 会员等级: </label>

									<div class="col-sm-3">
										<select id='did' class='col-sm-11' name='did'>
											<option value='3'>---请选择会员等级---</option>
										</select>
									</div>
									<label class="col-sm-1 control-label no-padding-right" for="form-field-1-1"> 会员生日: </label>

									<div class="col-sm-3">
										<input type="date" id='rbirthday' class="col-sm-11" name='rbirthday' />
									</div>
								</div>
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 卡上余额: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="0" id='rmoney' class="col-sm-11" name='rmoney' readonly="readonly" />
									</div>
									<label class="col-sm-1 control-label no-padding-right" for="form-field-1-1"> 卡上积分: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="0" id='rjf' class="col-sm-11" name='rjf' readonly="readonly" />
									</div>
								</div>
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 汽车颜色: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="    请输入汽车颜色" id='rcolor' class="col-sm-11" name='rcolor' />
									</div>
									<label class="col-sm-1 control-label no-padding-right" for="form-field-1-1"> 汽车牌号: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="    请输入汽车车牌" id='rcarnum' class="col-sm-11" name='rcarnum' />
									</div>
								</div>
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 汽车品牌: </label>

									<div class="col-sm-3">
										<select id='aid' class='col-sm-11' name='aid'>
											<option value='0'>---请选择汽车品牌---</option>
										</select>
									</div>
									<label class="col-sm-1 control-label no-padding-right" for="form-field-1-1"> 汽车系列: </label>

									<div class="col-sm-3">
										<select id='xid' class='col-sm-11' name='xid'>
											<option value='0'>---请选择汽车系列---</option>
										</select>
									</div>
								</div>
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 证件类型: </label>

									<div class="col-sm-3">
										<select id='zid' class='col-sm-11' name='zid'>
											<option value='0'>---请选择证件类型---</option>
										</select>
									</div>
									<label class="col-sm-1 control-label no-padding-right" for="form-field-1-1"> 证件编号: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="    请输入证件编号" id='rnum' class="col-sm-11" name='rnum' />
									</div>
								</div>
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 行驶里程: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="    请输入行驶里程" id='rway' class="col-sm-11" name='rway' />
									</div>
									<label class="col-sm-1 control-label no-padding-right" for="form-field-1-1"> 联系地址: </label>

									<div class="col-sm-3">
										<input type="text" placeholder="    请输入会员联系地址" id='raddress' class="col-sm-11" name='raddress' />
									</div>
								</div>
								<div class="form-group">
									<label class="col-sm-3 control-label no-padding-right" for="form-field-1-1"> 会员备注: </label>

									<div class="col-sm-7">
										<textarea class="form-control" name='rreamrk' id="rremark" placeholder="    请输入会员备注"></textarea>
									</div>
								</div>
								<div class="clearfix form-actions">
									<div class="col-md-offset-4 col-md-8 col-sm-6">
										<button class="btn btn-info" type="button" id='add'>
											<i class="ace-icon fa fa-check bigger-110"></i> 提交
										</button>

										&nbsp; &nbsp; &nbsp;
										<button class="btn" type="reset" id='reset'>
											<i class="ace-icon fa fa-undo bigger-110"></i> 重置
										</button>
									</div>
								</div>
							</form>
						</div>
					</div>
				</div>
			</div>
		</div>
	</div>
</body>
</html>